The Social Economics of Health Care

The Social Economics of Health Care

The Social Economics of Health Care

The Social Economics of Health Care

Synopsis

Issues such as privacy, genetic testing, and the allocation of organ transplants require a more sensitive approach to the setting of budgets, and so a more socially responsible attitude towards health care economics is emerging. John Davies has gathered together an impressive range of contributors to explore this phenomenon.

Excerpt

John B. Davis

A Social Economics of Health Care begins with recognition of the central role that a diverse array of social values play in determining the delivery and distribution of health care resources in contempory economies. Current health care economics, in contrast, generally restricts its attention to the values of efficiency and individual preference satisfaction, and moreover assumes that the market and an exchange-based organization of health care will resolve complex social issues regarding who shall have what health care. Since Amartya Sen’s critique of the dominant approach in economics as ‘welfarist,’ however, economists have begun to question the narrowness of their normative framework. These doubts are particularly unsettling for health economics, since the subject of health concerns individuals’ well-being in an especially personal and fundamental manner. Thus, unlike many other subjects economists investigate, the subject of delivery and distribution of health care immediately raises questions regarding equity, fairness, need, rights, trust, caring, and dignity alongside economists’ usual concerns with welfare and good consequences. To complicate matters further, these additional social values concerns are not easily explained within the framework of the market as an impersonal exchange between atomistic individuals. Indeed, relationships between health care providers and patients can be highly personalized, and the institutions that modern societies have created to provide health care often depend upon people sharing a very real sense of community with one another.

Thus emphasis on social values in a Social Economics of Health Care implies fundamental changes in the way health economics is pursued. The eleven chapters in this volume make valuable contributions to this alternative orientation. In different ways, they each exhibit the complexities involved in providing economic understanding of subjects that contain significant social and ethical components. The volume as a whole is divided into four parts. The chapers in the first part, ‘Alternatives to the market view of health care and health economics,’ examine contemporary health economics and its market-based view of health care. The chapters in the second part, ‘Resistance to market-based reform of health care systems,’

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